Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Ortho > Treatment Considertion In Orthognathic Surgery (Resisdent) > Flashcards

Treatment Considertion In Orthognathic Surgery (Resisdent) Flashcards

1
Q

What to consider for treatment?

A

Age of pt
Type of skeletal problem
Severity of skeletal problem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Options for tx

A

Growth modification
Camouflage
Orthognathic surgery (pre surgical ortho, then surgery, then post surgical ortho)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What factors influence dental and facial esthetics?

A

Smile line
Amount of gum tissue that shows when pt smiles
Width of the smile
Midlines
Facial proportions
Facial symmetry
Age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the indication for surgery

A

Tx objectives and goals that are outside the range of ortho possibility, which changes with age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Sagittal split, Lefort I year

A

1960s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Two jaw procedures, improved ortho interaction year

A

1970s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Rigid internal fixation year

A

1980s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Procedural refinements, early distraction osteogenesis year

A

1990s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Mandible forward limitations

A

Less stability after about 8mm of advancement
Rotational pattern makes a difference

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Most successful mandibular advancement

A

Short face with rotation of the chin down

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Maxilla forward limitation

A

The longer the move, the less stable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the best way to treat class III problems

A

Maxillary surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is often desired from maxilla forward

A

Forward plus down

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Mandible back limitation

A

Difficult to control the ramus inclination at surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Maxilla down and maxilla wider limited by

A

The muscle force, soft tissue stretch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Ortho preparation for surgery must include removal of dental compensation for the skeletal deformity

A

Decompensation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Why is it important to tell pts things will get worse before they get better

A

Ortho prep for surgery often is reverse of conventional ortho treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Class II extraction pattern

A

Mandibular premolars
Decompensates flaring
Increases mandibular surgical movement
Finish with class III molars

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What may be necessary for class II patients

A

To extract lower premolars or use class III elastics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Class III extraction patterns

A

Maxillary premolars
Deompensates flaring
Increases maxillary surgical Movement
Finish with class II molars

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What may be necessary in class III patients

A

To extract upper premolars or use Class II elastics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Surgical ortho tx to increase facial height

A

Mandibular osteotomy
Rotate chin down

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Surgical ortho tx to decrease facial height

A

Maxillary Lefort osteotomy (impaction)
Rotate chin up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Surgical ortho tx deep bite pts

A

Post surgical leveling
Ext- some space is left open prior to surgery
After surgery - pts significant posterior open bite is closed using vertical elastics
Increases the lower facial height of the deep bite pt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Surgical ortho tx open bite

A

Pre surgical leveling or surgical assisted leveling
Make the open bite significantly worse prior to surgery
Allows surgeon to establish proper vertical dimension on the pt during surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Pre surgical ortho - incisor position

A

Anterior posterior - exactly where they should be at completion or slightly over treated

27
Q

Incisor position pre surgery class II

A

Uppers slightly protrusive, lowers slightly retracted

28
Q

Incisor position pre surgery class III

A

Uppers slightly retrusive, lowers slightly protracted

29
Q

Pre surgical ortho - obtain arch compatibility

A

Transverse
Watch arch form
Canine width may need adjustment
Several study models

30
Q

What does the surgeon do if the 2nd molars or canines are in the way at the time of surgery

A

Surgeon will correct by grinding on enamel in operating room

31
Q

General rule

A

Should not take more than a year to get a pt ready for orthognathic surgery

32
Q

What can wait until after surgery

A

Extrusion (leveling)
Root paralleling

33
Q

What do you have to do before surgery

A

Intrusion
AP incisor positioning
Everything necessary to set it up for finishing in 6 months post surgery

34
Q

When is the pt ready for surgery

A

When the ortho thinks the pt is ready

35
Q

Final surgical planning

A

Stabilizing arch wires- stainless steel, fully engaged
Soldered or welded lugs on arch wires
Records
Final surgical prediction - cephalometric
Model surgery - surgeon does

36
Q

Why is it important for the ortho to see the results of the model surgery

A

Details of occlusion that make no difference to the surgeon can greatly affect time in finishing/post-surgical orthodontics

37
Q

Surgical splints advantages

A

Less reliance on surgeons judgement as to placement in operating room
Less pre surgical ortho needed

38
Q

Surgical splint guideline

A

Thin splint preferred

39
Q

Stabilizing arch wires goal

A

Prevent tooth movement

40
Q

Stabilizing arch wires- 18 slot brackets

A

17x25 stainless steel wire

41
Q

Stabilizing arch wires - 22 slot brackets

A

21x25 TMA or stainless steel wires

42
Q

Post operative expectations

A

Lots of swelling
Short term parenthesis of infraorbital nerve (maxilla) and IAN (mandible)
Significant pain is uncommon due to parenthesis
Usually, 1 overnight hospital stay per jaw

43
Q

Potential complications

A

Long term sensory impairment, more common in BSSO
20% of young patients with increase incidence with age

44
Q

Mandibular techniques

A

Intraoral vertical ramus osteotomy (IVRO)
Bilateral sagittal split osteotomy (BSSO)
Genioplasty

45
Q

IVRO advantages

A

Lower incidence of nerve injury

46
Q

IVRO disadvantages

A

Requires maxillomandibular fixation
Setback only

47
Q

BSSO Advantages

A

Versatility
Maxillomandibular fixation usually not necessary

48
Q

BSSO disadvantages

A

Nerve injury

49
Q

Genioplasty

A

Osteotomy versus implant
Osteotomy is highly versatile allowing for movement of the chin in all directions
Implants can only augment chin
Reports of bone resorption under implants

50
Q

Lower body osteotomy to reposition - up

A

Wedge reduction

51
Q

Lower body osteotomy to reposition- forward

A

Lower border osteotomy or implant

52
Q

Lower body osteotomy to reposition- transversely

A

Back

53
Q

Maxillary techniques

A

Lefort osteotomy

54
Q

Lefort osteotomy

A

High degree of versatility
Movements limited by anatomic structures, soft tissues
Large movements= grafting
Dental injury rare if osteotomy is kept 5 mm above apices
May be segmented into 2-3 pieces

55
Q

Choices to surgically widen maxilla

A

Surgically assisted rapid palatal expansion (SARPE) followed by LeFort osteotomy
Segmental LeFort osteotomy

56
Q

SARPE

A

Better stability

57
Q

Segmental Lefort osteotomy

A

One surgery, amount of expansion limited by soft tissue

58
Q

Two jar surgery indications

A

Deformities in both maxilla and mandible
Deformity in one jaw requiring a large, unstable movement

59
Q

Adjunctive procedrures

A

Blepharoplasty
Ostoplasty
Rhinoplasty
Rhytidectomy
Laser resurfacing

60
Q

Blepharoplasty

A

Excess skin —> upper eyelids, bagginess —> lower eyelids

61
Q

Otoplasty

A

Reduce prominence of the ears

62
Q

rhinoplasty

A

Cosmetic nose surgery

63
Q

Rhytidectomy

A

Complete facelift, for deep wrinkles

64
Q

Laser resurfacing

A

Fine wrinkles

Ortho (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions